DESCRIPTION: The proposed project is a cross-sectional and longitudinal clinical study of oral manifestations of HIV and periodontal disease status among a rural population of 675 HIV- infected persons in North Carolina, of whom approximately 54% will be blacks and 25% will be women; two year longitudinal follow-up is expected to be available in 381 persons. The principal investigator, Dr. Patton will administer a standardized interview questionnaire, conduct an oral clinical examination, and supervise collection of data from medical records on medical history, HIV disease classification, CD4 count, and medication; the patients will be referred from the HIV clinic at the same institution. The study will assess the impact of illicit drugs, alcohol, tobacco, gender, and race, as well as CD4 counts and disease status on the oral manifestations of HIV disease.The hypotheses are that HIV- infected blacks in rural North Carolina will have a greater extent and severity of periodontal disease, that differential access to oral health care may play an important role in oral disease progression, and that oral clinical signs of HIV infection play a critical role in initial serologic HIV diagnosis in blacks and females in the Southeast.